Limitations
In this study we used USS to diagnose NAFLD instead of the gold standard
liver biopsy. USS is a non-invasive, acceptable and feasible alternative
method, especially in pregnant women. The sensitivity of the diagnosis
of fatty liver in ultrasound scans ranges from 60-94%, and the
specificity is from 84-95%. The sensitivity of detecting fatty liver is
increased when the degree of fatty liver is increased. In morbid
obesity, sensitivity and specificity are reduced from 49-75% due to
technical errors. However, evidence shows that the reliability of USS
for diagnosing fatty liver is higher than that of histology in people
with moderate and severe fatty liver. In addition, the grading of fatty
liver is subjective and operator-dependent 12. The
objective of the FL scan in our study is risk prediction rather than a
precise diagnosis of steatosis, and for that purpose, routine USS will
be adequate.
The wide confidence intervals are due to the relatively low number of
GDM reported show the need for a study with a larger sample size for
better estimates of risk. Application of latest WHO criteria37 led to exclusion of 66 pregnant women from the
baseline assessment whom should not be excluded if the previous
classification was used.